Is the occurrence of atrial tachycardia a step towards sinus rhythm, after ablation of persistent atrial fibrillation (AF)? The results of the study by Ammar S et al [Arrhythmia Type After Persistent Atrial Fibrillation Ablation Predicts Success of the Repeat Procedure. Circulation: Arrhythmia and Electrophysiology. 2011; 4: 609-614] seems to point in that direction. They evaluated about eighty patients who underwent one or more repeat ablation for persistent atrial fibrillation. The initial ablation was pulmonary vein isolation with an extra substrate modification in the form of ablation of complex fractionated electrograms or linear ablations. Reablation was either for persistent atrial tachycardia, persistent AF or paroxysmal AF. The primary end point of the study was taken as freedom from any arrhythmia, off anti arrhythmic medications, for a period of six to nine months after the repeat ablation. It was found that those who presented with atrial tachycardia had a significantly better outcome than those who had a recurrence of persistent atrial fibrillation. Thus the authors concluded that the occurrence of atrial tachycardia after ablation for persistent atrial fibrillation may be considered as a step in the right direction – towards sinus rhythm.
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